Healthcare Provider Details

I. General information

NPI: 1205225752
Provider Name (Legal Business Name): STEWARD MEDICAL GROUP EXPRESS CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 MILLER ST
QUINCY MA
02169-4725
US

IV. Provider business mailing address

500 BOYLSTON ST
BOSTON MA
02116-3740
US

V. Phone/Fax

Practice location:
  • Phone: 617-419-4700
  • Fax:
Mailing address:
  • Phone: 617-419-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE CLAIRMONT
Title or Position: PRESIDENT OF STEWARD MEDICAL GROUP
Credential: MD
Phone: 617-419-4737